HOUSE JOURNAL EIGHTY-FIRST LEGISLATURE, REGULAR SESSION PROCEEDINGS

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1 HOUSE JOURNAL EIGHTY-FIRST LEGISLATURE, REGULAR SESSION PROCEEDINGS SEVENTY-THIRD DAY MONDAY, MAY 18, 2009 The house met at 10 a.m. and was called to order by the speaker pro tempore. The roll of the house was called and a quorum was announced present (Recordi924). Present Mr. Speaker; Allen; Alonzo; Alvarado; Anchia; Anderson; Aycock; Berman; Bohac; Bolton; Bonnen; Branch; Brown, B.; Brown, F.; Burnam; Button; Callegari; Castro; Chavez; Chisum; Christian; Cohen; Coleman; Cook; Corte; Crabb; Craddick; Creighton; Crownover; Darby; Davis, J.; Davis, Y.; Deshotel; Driver; Dukes; Dunnam; Dutton; Edwards; Eiland; Eissler; Elkins; England; Farabee; Farias; Farrar; Fletcher; Flores; Flynn; Gallego; Gattis; Geren; Giddings; Gonzales; Gonzalez Toureilles; Guillen; Gutierrez; Hamilton; Hancock; Hardcastle; Harless; Harper-Brown; Hartnett; Heflin; Hernandez; Herrero; Hilderbran; Hochberg; Hodge; Homer; Hopson; Howard, C.; Howard, D.; Hughes; Hunter; Isett; Jackson; Jones; Keffer; Kent; King, P.; King, S.; King, T.; Kleinschmidt; Kolkhorst; Laubenberg; Legler; Leibowitz; Lewis; Lucio; Madden; Maldonado; Mallory Caraway; Marquez; Martinez; Martinez Fischer; McCall; McClendon; McReynolds; Menendez; Merritt; Miklos; Miller, D.; Miller, S.; Moody; Morrison; Naishtat; Oliveira; Olivo; Orr; Ortiz; Otto; Parker; Patrick; Paxton; Peña; Phillips; Pickett; Pierson; Pitts; Quintanilla; Raymond; Riddle; Rios Ybarra; Ritter; Rodriguez; Rose; Sheffield; Shelton; Smith, T.; Smith, W.; Smithee; Solomons; Strama; Swinford; Taylor; Thibaut; Thompson; Truitt; Turner, C.; Turner, S.; Vaught; Veasey; Villarreal; Vo; Walle; Weber; Woolley; Zerwas. Absent, Excused Frost; Kuempel. The invocation was offered by Father Jimmie Drennan, St. Joseph Catholic Church Honey Creek, Spring Branch, as follows: Faithful God and creator of all, we gather today in the great State of Texas to make choices that will better individuals, families, communities, and our entire state. As we gather, we must pause to consider who we are and where we have come from, for if we fail to do so, we will become victims of our own ignorance. We, who gather this day, represent every person who lives in, travels through, or visits our state. We have been shaped by the events and the people who preceded us, and therefore always remember these forces that have helped create the shared vision of our land. Our parents and grandparents, our educators

2 st LEGISLATURE REGULAR SESSION and ministers, our friends and neighbors, have placed within our being a lasting impression. We must remember where we have come from in order to faithfully serve those of this generation and the generations that follow. God of all people, inspire our legislators to understand the complex diversity of our state. Bring to their hearts and minds the realization that our unity has in the past, currently rests, and will always remain in our diversity. We pray that each member of this house considers and faithfully makes choices that ensure the rights and liberties of every person in our state. We are black and white, Hispanic, Asian, and Native American; our state s faith is Jewish and Christian, Muslim and Hindu. We are young and old, single and married, native-born and immigrant, disabled and abled; so many of us are poor and many are rich. We are struggling to keep our home and many of our people are homeless. Many of our people are mentally ill and every person is in need of good healthcare and education. Make choices this day and everyday to meet the needs of all our people. Leave no person, however seemingly insignificant we may seem, out of your decisions. We as a nation stand on the threshold of great change. We are proud of much of our past and even more proud of changing and reshaping the shameful moments, experiences, and episodes of our history. May this spirit of hope, change, and certainty that has reshaped the highest levels of our national government rest upon those who lead our state. Lord and God, renew in all of us a commitment to care for our world and all its resources. May all who hold the authority to bring an end to war, violence, and terrorism make choices that restore peace to every corner of our world. May this peace allow all men and women who have been called to battle a return to their homeland and a reunion with their loved ones. This we ask in your name, you who live and reign forever and ever. The chair recognized Representative Martinez Fischer who led the house in the pledges of allegiance to the United States and Texas flags. CAPITOL PHYSICIAN The speaker pro tempore recognized Representative Thompson who presented Dr. John Redman of Humble as the "Doctor for the Day." The house welcomed Dr. Redman and thanked him for his participation in the Physician of the Day Program sponsored by the Texas Academy of Family Physicians. LEAVES OF ABSENCE GRANTED The following member was granted leave of absence for today and the remainder of the week because of illness: Kuempel on motion of Geren. The following member was granted leave of absence for today because of important business in the district: Frost on motion of Farabee.

3 Monday, May 18, 2009 HOUSE JOURNAL 73rd Day 3805 BILLS AND RESOLUTIONS SIGNED BY THE SPEAKER Notice was given at this time that the speaker had signed bills and resolutions in the presence of the house (see the addendum to the daily journal, Signed by the Speaker, House List No. 32). LEAVE OF ABSENCE GRANTED The following member was granted leave of absence for the remainder of today because of important business in the district: Vaught on motion of Leibowitz. HR ADOPTED (by Hernandez) Representative Hernandez moved to suspend all necessary rules to take up and consider at this time HRi2147. The motion prevailed. The following resolution was laid before the house: HR 2147, In memory of Captain James Arthur Harlow, Sr., of the Houston Fire Department. HR 2147 was read and was unanimously adopted by a rising vote. On motion of Representative Alvarado, the names of all the members of the house were added to HRi2147 as signers thereof. INTRODUCTION OF GUESTS The chair recognized Representative Hernandez who introduced family members of Captain James Arthur Harlow, Sr. HR ADOPTED (by Bonnen, et al.) Representative Bonnen moved to suspend all necessary rules to take up and consider at this time HRi2055. The motion prevailed. The following resolution was laid before the house: HR 2055, In memory of Houston firefighter and Alvin native Damion Jon Hobbs. HR 2055 was read and was unanimously adopted by a rising vote. On motion of Representative Weber, the names of all the members of the house were added to HRi2055 as signers thereof. INTRODUCTION OF GUESTS The chair recognized Representative Bonnen who introduced family members of Damion Jon Hobbs.

4 st LEGISLATURE REGULAR SESSION HR ADOPTED (by Marquez) Representative Marquez moved to suspend all necessary rules to take up and consider at this time HRi2167. The motion prevailed. The following resolution was laid before the house: HR 2167, Commending Maria Ruiz for her dedication to assisting children in Juarez. HR 2167 was adopted. On motion of Representatives Quintanilla and Moody, the names of all the members of the house were added to HRi2167 as signers thereof. COMMITTEE GRANTED PERMISSION TO MEET Representative McClendon requested permission for the Committee on Rules and Resolutions to meet while the house is in session, at 10:55 a.m. today, in 3W.9, for a formal meeting, to consider the calendar. Permission to meet was granted. COMMITTEE MEETING ANNOUNCEMENT The following committee meeting was announced: Rules and Resolutions, 10:55 a.m. today, 3W.9, for a formal meeting, to consider the calendar. HR ADOPTED (by Button, Vo, McCall, Hochberg, and C. Howard) Representative Button moved to suspend all necessary rules to take up and consider at this time HRi1759. The motion prevailed. The following resolution was laid before the house: HR 1759, Recognizing May 2009 as Asian/Pacific American Heritage Month. HR 1759 was adopted. On motion of Representatives D. Miller and Isett, the names of all the members of the house were added to HRi1759 as signers thereof. INTRODUCTION OF GUESTS The chair recognized Representative Button who introduced a delegation celebrating Asian/Pacific American Heritage Month.

5 Monday, May 18, 2009 HOUSE JOURNAL 73rd Day 3807 HR ADOPTED (by Jackson) Representative Jackson moved to suspend all necessary rules to take up and consider at this time HRi2157. The motion prevailed. The following resolution was laid before the house: HR 2157, Recognizing Jimmy Niemann for his service on the Addison City Council. HR 2157 was adopted. HCR ADOPTED (by Truitt) Representative Truitt moved to suspend all necessary rules to take up and consider at this time HCRi226. The motion prevailed. The following resolution was laid before the house: HCR 226, Commemorating the 125th anniversary of the Lucchese Boot Company. HCR 226 was adopted. On motion of Representative Hopson, the names of all the members of the house were added to HCRi226 as signers thereof. INTRODUCTION OF GUESTS The chair recognized Representative Truitt who introduced representatives of the Lucchese Boot Company. HB 3 - HOUSE REFUSES TO CONCUR IN SENATE AMENDMENTS CONFERENCE COMMITTEE APPOINTED Representative Eissler called up with senate amendments for consideration at this time, HB 3, A bill to be entitled An Act relating to public school accountability, curriculum, and promotion requirements. Representative Eissler moved that the house not concur in the senate amendments and that a conference committee be requested to adjust the differences between the two houses on HB 3. The motion prevailed. The chair announced the appointment of the following conference committee, on the part of the house, on HB 3: Eissler, chair; Hochberg, Keffer, Villarreal, and Dutton.

6 st LEGISLATURE REGULAR SESSION HB HOUSE CONCURS IN SENATE AMENDMENTS TEXT OF SENATE AMENDMENTS Representative Smithee called up with senate amendments for consideration at this time, HB 2064, A bill to be entitled An Act relating to premium discounts for certain participants in the Texas Health Insurance Risk Pool and to related tax credits for health benefit plan issuers. Representative Smithee moved to concur in the senate amendments to HBi2064. The motion to concur in the senate amendments to HB 2064 prevailed by (Record 925): 141 Yeas, 0 Nays, 1 Present, not voting. Yeas Allen; Alonzo; Alvarado; Anchia; Anderson; Aycock; Berman; Bohac; Bolton; Bonnen; Branch; Brown, B.; Brown, F.; Burnam; Button; Callegari; Castro; Chisum; Christian; Cohen; Coleman; Cook; Corte; Crabb; Craddick; Creighton; Crownover; Darby; Davis, J.; Davis, Y.; Deshotel; Driver; Dukes; Dunnam; Dutton; Eiland(C); Eissler; Elkins; England; Farabee; Farrar; Fletcher; Flores; Flynn; Gallego; Gattis; Geren; Giddings; Gonzales; Gonzalez Toureilles; Guillen; Gutierrez; Hamilton; Hancock; Hardcastle; Harless; Harper-Brown; Hartnett; Heflin; Hernandez; Herrero; Hilderbran; Hochberg; Hodge; Homer; Hopson; Howard, C.; Howard, D.; Hughes; Hunter; Isett; Jackson; Jones; Keffer; Kent; King, P.; King, S.; King, T.; Kleinschmidt; Kolkhorst; Laubenberg; Legler; Leibowitz; Lewis; Lucio; Madden; Maldonado; Mallory Caraway; Marquez; Martinez; Martinez Fischer; McCall; McClendon; McReynolds; Menendez; Merritt; Miller, D.; Miller, S.; Moody; Morrison; Naishtat; Oliveira; Olivo; Orr; Ortiz; Otto; Parker; Patrick; Paxton; Peña; Phillips; Pickett; Pierson; Pitts; Quintanilla; Raymond; Riddle; Rios Ybarra; Ritter; Rodriguez; Rose; Sheffield; Shelton; Smith, T.; Smith, W.; Smithee; Solomons; Strama; Swinford; Taylor; Thibaut; Thompson; Truitt; Turner, C.; Turner, S.; Veasey; Villarreal; Vo; Weber; Woolley; Zerwas. Present, not voting Mr. Speaker. Absent, Excused Frost; Kuempel; Vaught. Absent Chavez; Edwards; Farias; Miklos; Walle. STATEMENT OF VOTE When Record No. 925 was taken, I was temporarily out of the house chamber. I would have voted yes. Miklos Senate Amendment No. 1 (Senate Floor Amendment No. 1) Amend HB 2064 (Senate committee report) as follows: (1)iiAdd the following appropriately numbered SECTIONS to the bill and renumber subsequent SECTIONS of the bill accordingly: SECTIONi.iiSection , Insurance Code, is amended by adding Subsections (m) and (n) to read as follows:

7 Monday, May 18, 2009 HOUSE JOURNAL 73rd Day 3809 (m)iinotwithstanding any other provision of this section, this subsection governs the payment of a penalty under this section. For a penalty under this section relating to a clean claim submitted by a physician or provider other than an institutional provider, the health maintenance organization shall pay the entire penalty to the physician or provider, except for any interest computed under Subsection (c), which shall be paid to the Texas Health Insurance Risk Pool. For a penalty under this section relating to a clean claim submitted by an institutional provider, the health maintenance organization shall pay 50 percent of the total penalty amount computed under this section, including interest, to the institutional provider and the remaining 50 percent of that amount to the Texas Health Insurance Risk Pool. (n)iiin this section, "institutional provider" means a hospital or other medical or health-related service facility that provides care for the sick or injured or other care that may be covered in an evidence of coverage. SECTIONi.iiSection , Insurance Code, is amended by adding Subsection (l) to read as follows: (l)iinotwithstanding any other provision of this section, this subsection governs the payment of a penalty under this section. For a penalty under this section relating to a clean claim submitted by a preferred provider other than an institutional provider, the insurer shall pay the entire penalty to the preferred provider, except for any interest computed under Subsection (c), which shall be paid to the Texas Health Insurance Risk Pool. For a penalty under this section relating to a clean claim submitted by an institutional provider, the insurer shall pay 50 percent of the penalty amount computed under this section, including interest, to the institutional provider and the remaining 50 percent of that amount to the Texas Health Insurance Risk Pool. (2)iiIn the recital to SECTION 1 of the bill (page 1, line 13), strike "adding Subsections (e-1) and (e-2)" and substitute "adding Subsection (e-1)". (3)iiIn SECTION 1 of the bill, in amended Section (e-1), Insurance Code (page 1, line 23), strike "Subsection (e-2)" and substitute "the availability of funds under Section ". (4)iiIn SECTION 1 of the bill (page 1, lines 38-44), strike added Section (e-2), Insurance Code. (5)iiIn SECTION 2 of the bill (page 1, line 47, through page 2, line 3), strike added Section , Insurance Code, and substitute the following new Section , Insurance Code: Sec.i iiFUNDING FOR PREMIUM DISCOUNTS. The board shall collect penalty payments and interest paid by health maintenance organizations as provided by Section and insurers as provided by Section The board may use funds collected under this section only to finance premium discounts under Section (e-1). The board may require a health maintenance organization or an insurer to make payments under this section and make reports concerning those payments in a manner determined by the board. (6)iiIn SECTION 3 of the bill (page 2, line 4), insert the following between "3." and "(a)":

8 st LEGISLATURE REGULAR SESSION (a)iisections and , Insurance Code, as amended by this Act, apply only to a penalty or interest on a penalty owed with respect to a clean claim paid on or after the effective date of this Act. A penalty or interest on a penalty owed with respect to a clean claim paid before the effective date of this Act is governed by the law in effect immediately before that date, and that law is continued in effect for that purpose. (7)iiIn SECTION 3(a) of the bill (page 2, lines 7 and 8), strike "2010" each place it appears and substitute "2011". (8)iiIn SECTION 3 of the bill, strike existing Subsection (b) (page 2, lines 11-14). (9)iiIn SECTION 3 of the bill, reletter subsections appropriately. Senate Amendment No. 2 (Senate Floor Amendment No. 2) Amend HB 2064 (senate committee report) as follows: (1)iiIn SECTION 4 of the bill (page 2, line 15) strike "September 1, 2009" and substitute "January 1, 2010". HB HOUSE CONCURS IN SENATE AMENDMENTS TEXT OF SENATE AMENDMENTS Representative Bohac called up with senate amendments for consideration at this time, HB 392, A bill to be entitled An Act relating to the availability and use of automated external defibrillators in nursing homes and related institutions. Representative Bohac moved to concur in the senate amendments to HBi392. The motion to concur in the senate amendments to HB 392 prevailed by (Record 926): 141 Yeas, 0 Nays, 2 Present, not voting. Yeas Allen; Alonzo; Alvarado; Anchia; Anderson; Aycock; Berman; Bohac; Bolton; Bonnen; Branch; Brown, B.; Brown, F.; Burnam; Button; Callegari; Castro; Chavez; Chisum; Christian; Coleman; Cook; Corte; Crabb; Craddick; Creighton; Crownover; Darby; Davis, J.; Davis, Y.; Deshotel; Driver; Dukes; Dunnam; Dutton; Edwards; Eissler; Elkins; England; Farabee; Farias; Farrar; Fletcher; Flores; Flynn; Gallego; Gattis; Geren; Gonzales; Gonzalez Toureilles; Guillen; Gutierrez; Hamilton; Hancock; Hardcastle; Harless; Harper-Brown; Hartnett; Heflin; Hernandez; Herrero; Hilderbran; Hochberg; Hodge; Homer; Hopson; Howard, C.; Howard, D.; Hughes; Hunter; Isett; Jackson; Jones; Keffer; Kent; King, P.; King, S.; King, T.; Kleinschmidt; Kolkhorst; Legler; Leibowitz; Lewis; Lucio; Madden; Maldonado; Mallory Caraway; Marquez; Martinez; Martinez Fischer; McClendon; McReynolds; Menendez; Merritt; Miklos; Miller, D.; Miller, S.; Moody; Morrison; Naishtat; Oliveira; Olivo; Orr; Ortiz; Otto; Parker; Patrick; Paxton; Peña; Phillips; Pickett; Pierson; Pitts; Quintanilla; Raymond; Riddle; Rios Ybarra; Ritter; Rodriguez; Rose; Sheffield; Shelton; Smith, T.; Smith, W.; Smithee; Solomons; Strama; Swinford; Taylor; Thibaut; Thompson; Truitt; Turner, C.; Turner, S.; Veasey; Villarreal; Vo; Walle; Weber; Woolley; Zerwas.

9 Monday, May 18, 2009 HOUSE JOURNAL 73rd Day 3811 Present, not voting Mr. Speaker; Eiland(C). Absent, Excused Frost; Kuempel; Vaught. Absent Cohen; Giddings; Laubenberg; McCall. Senate Committee Substitute CSHB 392, A bill to be entitled An Act relating to the availability and use of automated external defibrillators in nursing homes and related institutions. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTIONi1.iiSubchapter F, Chapter 242, Health and Safety Code, is amended by adding Section to read as follows: Sec.i iiAUTOMATED EXTERNAL DEFIBRILLATORS. (a) An institution shall have available for use at the institution an automated external defibrillator, as defined by Section , and shall comply with the training, use, and notification requirements of Chapter 779. (b)iian institution that does not have funds available for purposes of Subsection (a) may solicit gifts, grants, or donations to purchase or maintain an automated external defibrillator for use at the institution. (c)iian institution may not use an automated external defibrillator to treat a resident of the institution who has issued or executed an out-of-hospital do-not-resuscitate order under Subchapter C, Chapter 166. (d)iinotwithstanding Section (b), Civil Practice and Remedies Code, Section (a), Civil Practice and Remedies Code, applies to administration of emergency care using an automated external defibrillator by an employee or volunteer at an institution. (e)iian institution shall employ at least one person who is trained in the proper use of an automated external defibrillator. (e-1)iian institution is not required to comply with Subsections (a) and (e) until September 1, This subsection expires January 1, SECTIONi2.iiThis Act takes effect September 1, Senate Amendment No. 1 (Senate Floor Amendment No. 1) Amend CSHB 392 (senate committee printing) in SECTION 1 of the bill, by striking Section (c), Health and Safety Code (page 1, lines 24 through 27), and substituting the following: (c)iithe use of an automated external defibrillator must be consistent with a resident s advance directive executed or issued under Subchapter C, Chapter 166. HB HOUSE CONCURS IN SENATE AMENDMENTS TEXT OF SENATE AMENDMENTS Representative Ortiz called up with senate amendments for consideration at this time, HB 271, A bill to be entitled An Act relating to the designation of enterprise projects during a biennium. Representative Ortiz moved to concur in the senate amendments to HBi271.

10 st LEGISLATURE REGULAR SESSION The motion to concur in the senate amendments to HB 271 prevailed by (Record 927): 139 Yeas, 1 Nays, 2 Present, not voting. Yeas Allen; Alonzo; Alvarado; Anchia; Anderson; Aycock; Berman; Bohac; Bolton; Bonnen; Branch; Brown, B.; Brown, F.; Burnam; Button; Castro; Chavez; Chisum; Christian; Coleman; Cook; Corte; Craddick; Creighton; Crownover; Darby; Davis, J.; Davis, Y.; Driver; Dukes; Dunnam; Dutton; Edwards; Eissler; Elkins; England; Farabee; Farias; Farrar; Fletcher; Flores; Flynn; Gallego; Gattis; Geren; Giddings; Gonzales; Gonzalez Toureilles; Guillen; Gutierrez; Hamilton; Hancock; Hardcastle; Harless; Harper-Brown; Hartnett; Heflin; Hernandez; Herrero; Hilderbran; Hochberg; Hodge; Homer; Hopson; Howard, C.; Howard, D.; Hughes; Hunter; Isett; Jackson; Jones; Keffer; Kent; King, P.; King, S.; King, T.; Kleinschmidt; Kolkhorst; Legler; Leibowitz; Lewis; Lucio; Madden; Maldonado; Mallory Caraway; Marquez; Martinez; Martinez Fischer; McCall; McClendon; McReynolds; Menendez; Merritt; Miklos; Miller, D.; Moody; Morrison; Naishtat; Oliveira; Olivo; Orr; Ortiz; Otto; Parker; Patrick; Paxton; Peña; Phillips; Pickett; Pierson; Pitts; Quintanilla; Raymond; Riddle; Rios Ybarra; Ritter; Rodriguez; Rose; Sheffield; Shelton; Smith, T.; Smith, W.; Smithee; Solomons; Strama; Swinford; Taylor; Thibaut; Thompson; Truitt; Turner, C.; Turner, S.; Veasey; Villarreal; Vo; Walle; Weber; Woolley; Zerwas. Nays Crabb. Present, not voting Mr. Speaker; Eiland(C). Absent, Excused Frost; Kuempel; Vaught. Absent Callegari; Cohen; Deshotel; Laubenberg; Miller, S. Senate Committee Substitute CSHB 271, A bill to be entitled An Act relating to the designation of enterprise projects during a biennium. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTIONi1.iiSection (d), Government Code, is amended to read as follows: (d)iithe maximum number of enterprise projects that the bank may designate for each nominating body during any biennium is: (1)iisix, if the nominating body is the governing body of [four, plus two additional bonus projects the bank may award in] a municipality or county with a population of less than 250,000; or (2)iinine [six], if the nominating body is the governing body of a municipality or county with a population of 250,000 or more. SECTIONi2.iiSection (e), Government Code, is amended as follows: (e)iithe office may, during any biennium, designate multiple concurrent enterprise projects to a qualified business located at a qualified business site [in an enterprise zone]. SECTIONi3.iiThis Act takes effect September 1, 2009.

11 Monday, May 18, 2009 HOUSE JOURNAL 73rd Day 3813 LEAVE OF ABSENCE GRANTED The following member was granted leave of absence for the remainder of today because of important business in the district: Cohen on motion of Allen. HB HOUSE CONCURS IN SENATE AMENDMENTS TEXT OF SENATE AMENDMENTS Representative Hopson called up with senate amendments for consideration at this time, HB 448, A bill to be entitled An Act relating to requiring the Department of State Health Services to implement a provider choice system. Representative Hopson moved to concur in the senate amendments to HBi448. The motion to concur in the senate amendments to HB 448 prevailed by (Record 928): 143 Yeas, 0 Nays, 2 Present, not voting. Yeas Allen; Alonzo; Alvarado; Anchia; Anderson; Aycock; Berman; Bohac; Bolton; Bonnen; Branch; Brown, B.; Brown, F.; Burnam; Button; Callegari; Castro; Chavez; Chisum; Christian; Coleman; Cook; Corte; Crabb; Craddick; Creighton; Crownover; Darby; Davis, J.; Davis, Y.; Deshotel; Driver; Dukes; Dunnam; Dutton; Edwards; Eissler; Elkins; England; Farabee; Farias; Farrar; Fletcher; Flores; Flynn; Gallego; Gattis; Geren; Giddings; Gonzales; Gonzalez Toureilles; Guillen; Gutierrez; Hamilton; Hancock; Hardcastle; Harless; Harper-Brown; Hartnett; Heflin; Hernandez; Herrero; Hilderbran; Hochberg; Hodge; Homer; Hopson; Howard, C.; Howard, D.; Hughes; Hunter; Isett; Jackson; Jones; Keffer; Kent; King, P.; King, S.; King, T.; Kleinschmidt; Kolkhorst; Legler; Leibowitz; Lewis; Lucio; Madden; Maldonado; Mallory Caraway; Marquez; Martinez; Martinez Fischer; McCall; McClendon; McReynolds; Menendez; Merritt; Miklos; Miller, D.; Miller, S.; Moody; Morrison; Naishtat; Oliveira; Olivo; Orr; Ortiz; Otto; Parker; Patrick; Paxton; Peña; Phillips; Pickett; Pierson; Pitts; Quintanilla; Raymond; Riddle; Rios Ybarra; Ritter; Rodriguez; Rose; Sheffield; Shelton; Smith, T.; Smith, W.; Smithee; Solomons; Strama; Swinford; Taylor; Thibaut; Thompson; Truitt; Turner, C.; Turner, S.; Veasey; Villarreal; Vo; Walle; Weber; Woolley; Zerwas. Present, not voting Mr. Speaker; Eiland(C). Absent, Excused Cohen; Frost; Kuempel; Vaught. Absent Laubenberg. Senate Committee Substitute CSHB 448, A bill to be entitled An Act relating to requiring the Department of State Health Services to implement a provider choice system for certain vaccines. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTIONi1.iiSubchapter A, Chapter 161, Health and Safety Code, is amended by adding Section to read as follows:

12 st LEGISLATURE REGULAR SESSION Sec.i iiPROVIDER CHOICE SYSTEM. (a)iithe department shall implement a provider choice system for the vaccines for children program operated by the department under authority of 42 U.S.C. Section 1396s and the adult safety net vaccination program. (b)iithe department shall ensure that eligible health care providers participating in the vaccines for children program or the adult safety net vaccination program may select any licensed vaccine, including combination vaccines and any dosage forms that: (1)iiare recommended by the federal Advisory Committee on Immunization Practices; (2)iiare made available to the department by the Centers for Disease Control and Prevention of the United States Public Health Service; and (3)iifor adult vaccines, are on the department-approved list of vaccines offered by the adult safety net vaccination program. (c)iifor the purposes of this section, "equivalent vaccines" means two or more vaccines, excluding the influenza vaccine, that meet all of the following: (1)iiprotect a recipient of a vaccine against the same infection or infections; (2)iirequire the same number of doses; (3)iihave similar safety and efficacy profiles; and (4)iiare recommended for comparable populations by the Centers for Disease Control and Prevention of the United States Public Health Service. (d)iithe department shall provide a vaccine selected by a health care provider under Subsection (b) only if the cost to the department of providing the vaccine is not more than 115 percent of the lowest-priced equivalent vaccine. (e)iithis section does not apply in the event of a disaster or public health emergency, terrorist attack, hostile military or paramilitary action, or extraordinary law enforcement emergency. (f)iithe department shall convene the immunization work group established under Section and solicit its recommendations regarding development of a plan for the implementation of the provider choice system under this section. The plan shall include the education of participating health care providers about: (1)iiprocedures and distribution systems of the Centers for Disease Control and Prevention of the United States Public Health Service; and (2)iivaccine options, the enrollment process, ordering, accountability, and reporting procedures. SECTIONi2.iiEffective September 1, 2010, Section , Health and Safety Code, is repealed. SECTIONi3.iiThe Department of State Health Services shall implement all or part of the provider choice system under Section , Health and Safety Code, as added by this Act, as soon as it is determined to be feasible, provided, however, that the department shall complete implementation of the system not later than August 31, SECTIONi4.iiExcept as provided by this Act, this Act takes effect September 1, 2009.

13 Monday, May 18, 2009 HOUSE JOURNAL 73rd Day 3815 HB HOUSE CONCURS IN SENATE AMENDMENTS TEXT OF SENATE AMENDMENTS Representative Gutierrez called up with senate amendments for consideration at this time, HB 1363, A bill to be entitled An Act relating to the diabetes mellitus registry pilot program. Representative Gutierrez moved to concur in the senate amendments to HBi1363. The motion to concur in the senate amendments to HB 1363 prevailed by (Record 929): 128 Yeas, 14 Nays, 2 Present, not voting. Yeas Allen; Alonzo; Alvarado; Anchia; Berman; Bohac; Bolton; Bonnen; Branch; Brown, B.; Brown, F.; Burnam; Button; Callegari; Castro; Chavez; Chisum; Coleman; Cook; Corte; Craddick; Creighton; Crownover; Darby; Davis, J.; Davis, Y.; Deshotel; Driver; Dukes; Dunnam; Dutton; Eissler; Elkins; England; Farabee; Farias; Farrar; Fletcher; Flores; Gallego; Geren; Giddings; Gonzales; Gonzalez Toureilles; Guillen; Gutierrez; Hamilton; Hardcastle; Harless; Hartnett; Heflin; Hernandez; Herrero; Hilderbran; Hochberg; Hodge; Homer; Hopson; Howard, D.; Hughes; Hunter; Isett; Jackson; Jones; Keffer; Kent; King, P.; King, S.; King, T.; Kleinschmidt; Kolkhorst; Legler; Leibowitz; Lewis; Lucio; Maldonado; Mallory Caraway; Marquez; Martinez; Martinez Fischer; McCall; McClendon; McReynolds; Menendez; Merritt; Miklos; Miller, D.; Miller, S.; Moody; Morrison; Naishtat; Oliveira; Olivo; Orr; Ortiz; Otto; Parker; Patrick; Paxton; Peña; Pickett; Pierson; Pitts; Quintanilla; Raymond; Riddle; Rios Ybarra; Ritter; Rodriguez; Rose; Shelton; Smith, T.; Smith, W.; Smithee; Solomons; Strama; Swinford; Taylor; Thibaut; Thompson; Turner, C.; Turner, S.; Veasey; Villarreal; Vo; Walle; Woolley; Zerwas. Nays Anderson; Aycock; Christian; Crabb; Flynn; Gattis; Hancock; Harper-Brown; Howard, C.; Madden; Phillips; Sheffield; Truitt; Weber. Present, not voting Mr. Speaker; Eiland(C). Absent, Excused Cohen; Frost; Kuempel; Vaught. Absent Edwards; Laubenberg. Senate Committee Substitute CSHB 1363, A bill to be entitled An Act relating to the diabetes mellitus registry pilot programs. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTIONi1.iiSection 1, Chapter 706 (HB 2132), Acts of the 80th Legislature, Regular Session, 2007, is amended by amending Subsections (c), (d), and (e) and adding Subsections (d-1) and (g) to read as follows: (c)iithe department shall select to participate in the pilot program a public health district that serves a county with a population of less than two million and contains a municipality with a population of over one million. The department and the public health district shall create an electronic registry to track the

14 st LEGISLATURE REGULAR SESSION glycosylated hemoglobin level and the diagnosis codes of each person who has a laboratory test to determine that level performed at a clinical laboratory in the district. (d)iiexcept as provided by Subsection (d-1), a physician practicing in the participating public health district who, on or after November 1, 2009, orders a glycosylated hemoglobin test for a patient shall submit to the clinical laboratory the diagnosis codes of a patient along with the patient s sample. A clinical laboratory located in the participating public health district shall submit to the district and the department for a patient whose diagnosis codes were submitted with the patient s sample the results of the patient s [each] glycosylated hemoglobin test along with the diagnosis codes provided by the physician for that patient [that the laboratory performs]. (d-1)iia physician who orders a glycosylated hemoglobin test for a patient must provide the patient with a form developed by the department that allows the patient to opt out of having the patient s information included in the registry. If the patient opts out by signing the form, the physician: (1)iishall keep the form in the patient s medical records; and (2)iimay not submit to the clinical laboratory the patient s diagnosis codes along with the patient s sample. (e)iithe department and the participating public health district shall: (1)iicompile results submitted under Subsection (d) of this section in order to track: (A)iithe prevalence of diabetes mellitus among people tested in the district; (B)iithe level of diabetic control for the patients with diabetes mellitus in each demographic group [exert over the diabetes mellitus]; (C)iithe trends of new diagnoses of diabetes mellitus in the district; and (D)iithe health care costs associated with diabetes mellitus and glycosylated hemoglobin testing; and (2)iipromote discussion and public information programs regarding diabetes mellitus. (g)iinot later than October 1, 2009, the department shall develop and make available on its Internet website the form required under Subsection (d-1). SECTIONi2.iiSection 2, Chapter 706 (HB 2132), Acts of the 80th Legislature, Regular Session, 2007, is amended to read as follows: Sec.i2.iiRULES. The executive commissioner of the Health and Human Services Commission shall adopt rules to implement Section 1 of this Act, including rules to govern the format and method of collecting glycosylated hemoglobin data and patient diagnosis codes. SECTIONi3.iiSection 4, Chapter 706 (HB 2132), Acts of the 80th Legislature, Regular Session, 2007, is amended to read as follows:

15 Monday, May 18, 2009 HOUSE JOURNAL 73rd Day 3817 Sec.i4.iiREPORT. Not later than December 1, 2010 [2009], the Department of State Health Services shall submit a report to the governor, lieutenant governor, speaker of the house of representatives, and appropriate standing committees of the legislature regarding the diabetes mellitus registry pilot program that includes: (1)iian evaluation of the effectiveness of the pilot program; and (2)iia recommendation to continue, expand, or eliminate the pilot program. SECTIONi4.iiSection 5, Chapter 706 (HB 2132), Acts of the 80th Legislature, Regular Session, 2007, is amended to read as follows: Sec.i5.iiEXPIRATION. This Act expires September 1, 2011 [2010]. SECTIONi5.iiThis Act takes effect September 1, HB HOUSE CONCURS IN SENATE AMENDMENTS TEXT OF SENATE AMENDMENTS Representative Menendez called up with senate amendments for consideration at this time, HB 1342, A bill to be entitled An Act relating to adoption of certain information technology. Representative Menendez moved to concur in the senate amendments to HBi1342. The motion to concur in the senate amendments to HB 1342 prevailed by (Record 930): 139 Yeas, 0 Nays, 2 Present, not voting. Yeas Allen; Alonzo; Alvarado; Anchia; Anderson; Aycock; Berman; Bohac; Bolton; Bonnen; Branch; Brown, B.; Brown, F.; Burnam; Button; Callegari; Castro; Chavez; Christian; Coleman; Cook; Corte; Crabb; Craddick; Creighton; Crownover; Darby; Davis, J.; Deshotel; Driver; Dukes; Dunnam; Dutton; Eissler; Elkins; England; Farabee; Farias; Farrar; Fletcher; Flores; Flynn; Gallego; Gattis; Geren; Giddings; Gonzales; Gonzalez Toureilles; Guillen; Gutierrez; Hamilton; Hancock; Hardcastle; Harless; Harper-Brown; Hartnett; Heflin; Hernandez; Herrero; Hilderbran; Hochberg; Hodge; Homer; Hopson; Howard, C.; Howard, D.; Hughes; Hunter; Isett; Jackson; Jones; Keffer; Kent; King, P.; King, S.; King, T.; Kleinschmidt; Kolkhorst; Legler; Leibowitz; Lewis; Lucio; Madden; Maldonado; Mallory Caraway; Marquez; Martinez; Martinez Fischer; McClendon; McReynolds; Menendez; Merritt; Miklos; Miller, D.; Miller, S.; Moody; Morrison; Naishtat; Oliveira; Olivo; Orr; Ortiz; Otto; Parker; Patrick; Paxton; Peña; Phillips; Pickett; Pierson; Pitts; Quintanilla; Raymond; Riddle; Rios Ybarra; Ritter; Rodriguez; Rose; Sheffield; Shelton; Smith, T.; Smith, W.; Smithee; Solomons; Strama; Swinford; Taylor; Thibaut; Thompson; Truitt; Turner, C.; Turner, S.; Veasey; Villarreal; Vo; Walle; Weber; Woolley; Zerwas. Present, not voting Mr. Speaker; Eiland(C). Absent, Excused Cohen; Frost; Kuempel; Vaught. Absent Chisum; Davis, Y.; Edwards; Laubenberg; McCall.

16 st LEGISLATURE REGULAR SESSION Senate Committee Substitute CSHB 1342, A bill to be entitled An Act relating to adoption of certain information technology. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTIONi1.iiSubtitle J, Title 8, Insurance Code, is amended by adding Chapter 1661 to read as follows: CHAPTER INFORMATION TECHNOLOGY Sec.i iiDEFINITIONS. In this chapter: (1)ii"Health benefit plan" means a plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or an individual or group evidence of coverage that is offered by: (A)iian insurance company; (B)iia group hospital service corporation operating under Chapter 842; (C)iia fraternal benefit society operating under Chapter 885; (D)iia stipulated premium company operating under Chapter 884; (E)iia Lloyd s plan operating under Chapter 941; (F)iian exchange operating under Chapter 942; (G)iia health maintenance organization operating under Chapter 843; (H)iia multiple employer welfare arrangement that holds a certificate of authority under Chapter 846; (I)iian approved nonprofit health corporation that holds a certificate of authority under Chapter 844; or (J)iian entity not authorized under this code or another insurance law of this state that contracts directly for health care services on a risk-sharing basis, including a capitation basis. (2)ii"Health benefit plan issuer" means an entity authorized to issue a health benefit plan in this state. (3)ii"Health care provider" means: (A)iian individual who is licensed, certified, or otherwise authorized to provide health care services; or (B)iia hospital, emergency clinic, outpatient clinic, or other facility providing health care services. (4)ii"Participating provider" means a health care provider who has contracted with a health benefit plan issuer to provide services to enrollees. Sec.i iiUSE OF CERTAIN INFORMATION TECHNOLOGY REQUIRED. (a) A health benefit plan issuer shall use information technology that provides a participating provider with real-time information at the point of care concerning: (1)iithe enrollee s: (A)iicopayment and coinsurance; (B)iiapplicable deductibles; and (C)iicovered benefits and services; and

17 Monday, May 18, 2009 HOUSE JOURNAL 73rd Day 3819 (2)iithe enrollee s estimated total financial responsibility for the care. (b)iia health benefit plan issuer shall use information technology that provides an enrollee with information concerning the enrollee s: (1)iicopayment and coinsurance; (2)iiapplicable deductibles; (3)iicovered benefits and services; and (4)iiestimated financial responsibility for the health care provided to the enrollee. (c)iinothing in this section may be interpreted as a guarantee of payment for health care services. (d)iia health benefit plan issuer s Internet website may be used to meet the information technology requirements of this chapter. Sec.i iiEXCEPTIONS. This chapter does not apply to: (1)iia health benefit plan that provides coverage only: (A)iifor a specified disease or diseases or under a limited benefit policy; (B)iifor accidental death or dismemberment; (C)iias a supplement to a liability insurance policy; or (D)iifor dental or vision care; (2)iidisability income insurance coverage; (3)iicredit insurance coverage; (4)iia hospital confinement indemnity policy; (5)iia Medicare supplemental policy as defined by Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss); (6)iia workers compensation insurance policy; (7)iimedical payment insurance coverage provided under a motor vehicle insurance policy; (8)iia long-term care insurance policy, including a nursing home fixed indemnity policy, unless the commissioner determines that the policy provides benefits so comprehensive that the policy is a health benefit plan and should not be subject to the exemption provided under this section; (9)iithe child health plan program under Chapter 62, Health and Safety Code, or the health benefits plan for children under Chapter 63, Health and Safety Code; or (10)iia Medicaid managed care program operated under Chapter 533, Government Code, or a Medicaid program operated under Chapter 32, Human Resources Code. Sec.i iiREQUIRED USE OF TECHNOLOGY BY PROVIDERS. A physician, hospital, or other health care provider shall use information technology as required under this chapter beginning not later than September 1, Sec.i iiREFUND OF OVERPAYMENT. A physician, hospital, or other health care provider that receives an overpayment from an enrollee must refund the amount of the overpayment to the enrollee not later than the 30th day

18 st LEGISLATURE REGULAR SESSION after the date the physician, hospital, or health care provider determines that an overpayment has been made. This section does not apply to an overpayment subject to Section or Sec.i iiHEALTH BENEFIT PLAN ISSUER CONDUCT. ia contract between a health benefit plan issuer and a physician, hospital, or other health care provider may not prohibit the physician, hospital, or health care provider from collecting, at the time of care, the estimated amount for which the enrollee may be financially responsible. Sec.i iiCERTAIN FEES PROHIBITED. A health benefit plan issuer may not directly charge or collect from an enrollee or a physician, or other health care provider, a fee to cover the costs incurred by the health benefit plan issuer in complying with this chapter. Sec.i iiWAIVER. (a) A health benefit plan issuer may apply to the commissioner for a waiver of the requirement under this chapter to use information technology. (b)iithe commissioner by rule shall identify circumstances that justify a waiver, including: (1)iiundue hardship, including financial or operational hardship; (2)iithe geographical area in which the health benefit plan issuer operates; (3)iithe number of enrollees covered by a health benefit plan issuer; and (4)iiother special circumstances. (c)iithe commissioner shall approve or deny a waiver application under this section not later than the 60th day after the date of receipt of the application. (d)iithis section expires January 1, Sec.i iiRULES. (a) The commissioner shall adopt rules as necessary to implement this chapter, including rules that ensure that the information technology used by a health benefit plan issuer does not have legal or technical restrictions for encoding, displaying, exchanging, reading, printing, transmitting, or storing information or data in electronic form. (b)iirules adopted by the commissioner must be consistent with national standards established by the Workgroup for Electronic Data Interchange or by other similar organizations recognized by the commissioner. SECTIONi2.iiThis Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect January 1, Senate Amendment No. 1 (Senate Floor Amendment No. 1) Amend CSHB 1342 (Senate committee report) as follows: (1)iiIn SECTION 1 of the bill, in added Chapter 1661, Insurance Code (page 2, between lines 48 and 49), insert the following: Sec.i iiUSE OF TECHNOLOGY: WAIVER. (a) Notwithstanding Section , physicians or health care providers with fewer than five full-time-equivalent employees are not required to use information technology as required under this chapter.

19 Monday, May 18, 2009 HOUSE JOURNAL 73rd Day 3821 (b)iia health benefit plan issuer may not require, through contract or otherwise, physicians or health care providers with fewer than five full-time-equivalent employees to use information technology as required under this chapter. (c)iia contract between the issuer of a health benefit plan and a physician or health care provider must provide for a waiver of any requirement for the use of information technology as established or required under this chapter. (d)iithe commissioner shall establish the circumstances under which the requirements of this chapter do not apply to a physician or health care provider including: (1)iiundue hardship, including fiscal or operational hardship; or (2)iiany other special circumstance that would justify an exclusion. (e)iithe commissioner shall establish circumstances under which a waiver under Subsection (c) is required, including: (1)iiundue hardship, including fiscal or operational hardship; or (2)iiany other special circumstance that would justify a waiver. (f)iiany physician or health care provider that is denied a waiver by a health benefit plan issuer may appeal the denial to the commissioner. The commissioner shall determine whether a waiver must be granted. (g)iia health benefit plan issuer may not refuse to contract or renew a contract with a physician or health care provider based in whole or in part on the physician or provider requesting or receiving a waiver or appealing a waiver determination. A health benefit plan issuer may not refuse to contract or renew a contract with a physician or health care provider based in whole or in part on the physician or provider meeting the exemptions contained in Subsections (a) and (b). (h)iia waiver approved under this section expires September 1, (2)iiIn SECTION 1 of the bill, in added Section , Insurance Code (page 3, between lines 6 and 7), insert "(e)iia waiver approved under this section expires September 1, 2013." HB HOUSE CONCURS IN SENATE AMENDMENTS TEXT OF SENATE AMENDMENTS Representative McCall called up with senate amendments for consideration at this time, HB 1998, A bill to be entitled An Act relating to temporary housing and emergency shelters provided by a political subdivision for disaster victims. Representative McCall moved to concur in the senate amendments to HBi1998. The motion to concur in the senate amendments to HB 1998 prevailed by (Record 931): 140 Yeas, 0 Nays, 2 Present, not voting. Yeas Allen; Alonzo; Alvarado; Anchia; Anderson; Aycock; Berman; Bohac; Bolton; Bonnen; Branch; Brown, B.; Brown, F.; Burnam; Button; Callegari; Castro; Chavez; Chisum; Christian; Coleman; Cook; Corte; Crabb; Craddick; Creighton; Crownover; Darby; Davis, J.; Davis, Y.; Deshotel; Driver;

20 st LEGISLATURE REGULAR SESSION Dunnam; Dutton; Edwards; Eissler; Elkins; England; Farabee; Farias; Farrar; Fletcher; Flores; Flynn; Gallego; Gattis; Geren; Giddings; Gonzales; Gonzalez Toureilles; Guillen; Gutierrez; Hamilton; Hancock; Hardcastle; Harless; Harper-Brown; Hartnett; Heflin; Hernandez; Herrero; Hilderbran; Hochberg; Hodge; Homer; Hopson; Howard, C.; Howard, D.; Hughes; Hunter; Isett; Jackson; Jones; Keffer; Kent; King, P.; King, S.; King, T.; Kleinschmidt; Kolkhorst; Legler; Leibowitz; Lewis; Lucio; Madden; Maldonado; Mallory Caraway; Marquez; Martinez; Martinez Fischer; McCall; McClendon; McReynolds; Menendez; Merritt; Miklos; Miller, D.; Moody; Morrison; Naishtat; Oliveira; Olivo; Orr; Ortiz; Otto; Parker; Patrick; Paxton; Peña; Phillips; Pickett; Pierson; Pitts; Quintanilla; Raymond; Riddle; Rios Ybarra; Ritter; Rodriguez; Sheffield; Shelton; Smith, T.; Smith, W.; Smithee; Solomons; Strama; Swinford; Taylor; Thibaut; Thompson; Truitt; Turner, C.; Turner, S.; Veasey; Villarreal; Vo; Walle; Weber; Woolley; Zerwas. Present, not voting Mr. Speaker; Eiland(C). Absent, Excused Cohen; Frost; Kuempel; Vaught. Absent Dukes; Laubenberg; Miller, S.; Rose. Senate Committee Substitute CSHB 1998, A bill to be entitled An Act relating to temporary housing and emergency shelters provided by a political subdivision for disaster victims. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTIONi1.iiSection , Government Code, is amended by adding Subdivision (6-a) to read as follows: (6-a)ii"Public facility" has the meaning assigned by Section 102, Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. Section 5122). SECTIONi2.iiSection , Government Code, is amended to read as follows: Sec.i iiTEMPORARY HOUSING AND EMERGENCY SHELTER. (a)iithe governor may enter into purchase, lease, or other arrangements with an agency of the United States for temporary housing units to be occupied by disaster victims and may make units available to any political subdivision. (b)iithe governor may assist a political subdivision that is the locus of temporary housing or emergency shelters for disaster victims to acquire sites necessary for temporary housing or emergency shelters and to do all things required to prepare the sites to receive and use temporary housing units or emergency shelters by: (1)iiadvancing or lending funds available to the governor from any appropriation made by the legislature or from any other source; (2)iiallocating funds made available by a public or private agency; or (3)iibecoming a copartner with the political subdivision for the execution and performance of any temporary housing or emergency shelter project for disaster victims.